﻿
@{
    Layout = null;
}

<!DOCTYPE HTML PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
    <title>Untitled Document</title>
    <link rel="stylesheet" type="text/css" href="~/Content/BaiTap20/css/bootstrap.css" />
    <link rel="stylesheet" type="text/css" href="~/Content/BaiTap20/css/style.css" />
</head>

<body>
    <div class="container">
        <div id="mod_contact">
            <div class="contact_left">
                <div class="contact_title" style="font-size: 21px; color: #d5d5d5; margin: 1px; padding-left: 0px; height: 34px;">
                    <a href="#" class="contact_tab contact_tab_active">Gửi liên hệ</a>
                </div>
                <table class="contact_content" cellpadding="1" cellspacing="3">
                    <tbody>
                        <tr>
                            <td>
                                <table cellpadding="5" cellspacing="0" class="table_none">
                                    <tbody>
                                        <tr>
                                            <td colspan="2" style="text-align:center; font-family:Arial, Helvetica, sans-serif; font-size:14px; color:#153CF0;"></td>
                                        </tr>
                                        <tr>
                                            <td colspan="2" style="text-align:center; font-family:Arial, Helvetica, sans-serif; font-size:14px; color:#153CF0;"></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Danh xưng </td>
                                            <td class="coltdright">
                                                <select id="sex" name="sex" class="select">
                                                    <option value="not">==Chọn danh tính==</option>
                                                    <option value="Ong">Ông</option>
                                                    <option value="Bà">Bà</option>
                                                </select>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Họ và tên:</td>
                                            <td class="coltdright"><input class="textbox" type="text" name="name" id="name_contact" maxlength="50" style="width:400px;" value="" /><font color="red">(*)</font></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Địa chỉ:</td>
                                            <td class="coltdright"><input class="textbox" type="text" name="address" id="address_contact" maxlength="50" style="width:400px;" value="" /><font color="red">(*)</font></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Số điện thoại:</td>
                                            <td class="coltdright"><input class="textbox" type="text" name="tel" id="tel_contact" maxlength="50" style="width:400px;" value="" /><font color="red">(*)</font></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Email:</td>
                                            <td class="coltdright"><input class="textbox" type="text" name="email" id="email_contact" maxlength="50" style="width:400px;" value="" /><font color="red">(*)</font></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Liên hệ với bộ phận: </td>
                                            <td class="coltdright">
                                                <select id="dep" name="dep" class="select">
                                                    <option value="not">==Bộ phận==</option>
                                                    <option value="kt">Kỹ thuật</option>
                                                    <option value="kd">Kinh doanh</option>
                                                    <option value="tv">Tư vấn</option>
                                                </select>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft">Tiêu đề:</td>
                                            <td class="coltdright"><input class="textbox" type="text" name="title" id="title" maxlength="50" style="width:400px;" value="" /><font color="red">(*)</font></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft" style="vertical-align:top;">Nội dung:</td>
                                            <td class="coltdright" style="vertical-align:top;"><textarea name="content" id="content" wrap="hard" rows="10" cols="100" style="width:400px;"></textarea><font color="red">(*)</font></td>
                                        </tr>
                                        <tr>
                                            <td class="coltdleft" style="vertical-align:top;">Mã bảo mật:</td>
                                            <td class="coltdright" style="vertical-align:top;">
                                                <img id="captcha_img" alt="captcha" src="~/Content/BaiTap20/images/captcha.php" />
                                                <img id="reload_button" onclick="fn_reload_captcha()" src="~/Content/BaiTap20/images/indicator_arrows_static.gif" title="Tạo mã khác" />
                                                <input name="captcha" type="text" id="captcha" maxlength="3" />
                                                <font color="red">(*)</font> Bắt buộc điền thông tin
                                            </td>
                                        </tr>
                                        <tr>
                                            <td></td>
                                            <td style="padding-top: 24px;">
                                                <a href="javascript: void(0);" style="text-decoration: none; float: left" onclick="document.getElementById('ContactForm').submit();">
                                                    <div class="button_red">
                                                        <div class="left">
                                                            <div class="right">
                                                                <div class="center">Gửi liên hệ</div>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </a>
                                                &nbsp;&nbsp;
                                                <a href="javascript: void(0);" style="text-decoration: none; float: left" onclick="document.getElementById('ContactForm').reset();">
                                                    <div class="button_gray">
                                                        <div class="left">
                                                            <div class="right">
                                                                <div class="center">Nhập lại</div>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </a>
                                            </td>
                                        </tr>
                                    </tbody>
                                </table>
                            </td>
                        </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>
</body>
</html>


